HOSPICE ALLIANCE INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE ALLIANCE INC (EIN 39-1403883)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-10-19
- IRS object ID
- 201732929349300848
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-10-19T12:47:08-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 391648207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREA & ORENDORFF LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6300 76TH ST STE 200 | AddressLine1Txt |
| City | KENOSHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 531424018 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391403883 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE ALLIANCE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 2626524400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10220 PRAIRIE RIDGE BLVD | AddressLine1Txt |
| City | PLEASANT PRAIRIE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53158 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHUCK DUFORD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 2626524482 | PhoneNum |
| Signature | 2007-10-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI A SCHMIDT | PreparerPersonNm |
| PTIN | P00037140 | PTIN |
| Phone | 2626577716 | PhoneNum |
| Preparation | 2017-10-19 | PreparationDt |
Filing Security Information FilingSecurityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| At Submission Creation Device Id | F3543CC7BF6C365C69313107A5F8E030DA8CA74A | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 1356DCE4635ED09849660665C8192DC0602A1D36 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHUCK DUFORD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10220 PRAIRIE RIDGE BLVD | AddressLine1Txt |
| City | PLEASANT PRAIRIE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53158 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,483,148 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOSPICEALLIANCE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | HOSPICE ALLIANCE IS A NON-PROFIT ORGANIZATION DEDICATED TO CARING FOR THE TERMINALLY ILL AND EMPOWERING THOSE WHO SUPPORT THEM. WE STRIVE TO PROVIDE COMFORT IN ORDER TO ENHANCE THE QUALITY OF LIFE EACH DAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 134 | TotalEmployeeCnt |
| Total Volunteers | 160 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $308,602 | PYContributionsGrantsAmt |
| CY Contributions Grants | $238,997 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,130,365 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,131,010 | CYProgramServiceRevenueAmt |
| PY Investment Income | $827 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,943 | CYInvestmentIncomeAmt |
| PY Other Revenue | $75,037 | PYOtherRevenueAmt |
| CY Other Revenue | $111,198 | CYOtherRevenueAmt |
| PY Total Revenue | $8,514,831 | PYTotalRevenueAmt |
| CY Total Revenue | $7,483,148 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,108,047 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,385,729 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,690,118 | PYOtherExpensesAmt |
| CY Other Expenses | $2,112,345 | CYOtherExpensesAmt |
| PY Total Expenses | $9,798,165 | PYTotalExpensesAmt |
| CY Total Expenses | $7,498,074 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,283,334 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$14,926 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,959,787 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,966,763 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $460,855 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $482,757 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,498,932 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,484,006 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HOSPICE ALLIANCE HAS SERVED OVER 8,000 TERMINALLY ILL PATIENTS AND THEIR FAMILIES SINCE 1981; SERVICING KENOSHA, EASTERN WALWORTH, AND RACINE COUNTIES. HOSPICE ALLIANCE REMAINS COMMITTED TO CARING FOR THE TERMINALLY ILL AND EMPOWERING THOSE WHO SUPPORT THEM. INCORPORATED IN 1981 IN KENOSHA, WISCONSIN, HOSPICE ALLIANCE, INC. WAS ESTABLISHED BY A GROUP OF COMMUNITY CITIZENS THAT WERE CONCERNED WITH THE LACK OF END OF LIFE CARE AVAILBLE TO TERMINALLY ILL PERSONS AND THEIR FAMILIES. THESE COMMUNITY CITIZENS BELIEVED THAT IF TERMINALLY ILL PEOPLE WERE GIVEN A CHOICE AS TO WHERE THEY WOULD LIKE TO BE, IT WOULD BE IN THEIR HOME SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. HOSPICE ALLIANCE, INC. LIVES THIS MISSION DAILY THROUGH COMMITMENT, COMPASSION, AND CHOICES. HOSPICE ALLIANCE, INC. PROVIDES CARE IN THE FOLLOWING SETTINGS: 1. IN THE PATIENT'S HOME, SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. THIS CHOICE ALLOWS FAMILY AND FRIENDS TO SUPPORT THEIR LOVED ONE IN COMFORT AND PRIVACY. 2. IN | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,620,884 | ExpenseAmt |
| Desc | HOSPICE ALLIANCE PROVIDED 45,616 DAYS OF SERVICE WHICH INCLUDES, 1,527 DAYS OF RESIDENTIAL HOSPICE CARE IN OUR HOSPICE HOUSE IN 2016 | Desc |
| Total Program Service Expenses | $5,620,884 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 22 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 134 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AARON BLACKMOR CPA | PersonNm |
| Phone | 8282331180 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1611 ASHEVILLE HIGHWAY | AddressLine1Txt |
| City | HENDERSONVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28791 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| COLIN CARTER | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL LANGENDORF | |||||||
| PAST PRESIDE | Yes (X) | $0 | $0 | $0 | |||
| DAVID KNIGHT MD | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| JOSHUA BLOOM MD | |||||||
| MEDICAL DIR | Yes (X) | $17,600 | $0 | $0 | 10.00 | ||
| SHERYL MUELLER | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| GENE OLSON | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| NANCY PIASECKI | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| JOHN PLOUS | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| RACHAEL PROKO-VIOLA | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| SANDRA RIESE | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| MARY ANN CARDINALI RN | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| THOMAS TENUTA | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| PAMELA THOMEY | |||||||
| MEMBER | Yes (X) | $0 | $0 | $0 | |||
| DANIEL HEYDEN CPA | |||||||
| SEC / TREAS | $0 | $0 | $0 | Yes (X) | |||
| CHUCK DUFORD | |||||||
| PRESIDENT | $0 | $0 | $0 | Yes (X) | |||
| MYLES MULLIKIN | |||||||
| VICE PRESIDE | $0 | $0 | $0 | Yes (X) | |||
| ABDUL DURRANI | |||||||
| MEDICAL DOCT | $115,440 | $0 | $0 | Yes (X) | |||
| RITA HAGEN RN MSN | |||||||
| EXEC DIRECTR | $129,209 | $0 | $0 | 50.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $262,249 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Related Organizations | $238,997 | RelatedOrganizationsAmt |
| Noncash Contributions | $188,997 | NoncashContributionsAmt |
| Total Contributions | $238,997 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| NET PATIENT SERVICE REVENUE | $6,674,736 | $6,674,736 |
| HOSPICE HOUSE REVENUE | $456,274 | $456,274 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,131,010 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,943 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,943 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| OTHER REVENUE | $59,100 | $59,100 |
| ADMINISTRATION FEES-FDN | $52,098 | $52,098 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $111,198 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,483,148 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,244,151 | RelatedOrExemptFuncIncomeAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,393,538 | TotalAmt |
| Program Services | $3,193,820 | ProgramServicesAmt |
| Management And General | $1,199,718 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $677,210 | TotalAmt |
| Program Services | $483,693 | ProgramServicesAmt |
| Management And General | $193,517 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,981 | TotalAmt |
| Program Services | $226,434 | ProgramServicesAmt |
| Management And General | $88,547 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,113 | TotalAmt |
| Program Services | $2,957 | ProgramServicesAmt |
| Management And General | $1,156 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,983 | TotalAmt |
| Program Services | $10,771 | ProgramServicesAmt |
| Management And General | $4,212 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,048 | TotalAmt |
| Program Services | $40,048 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,916 | TotalAmt |
| Management And General | $84,916 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,773 | TotalAmt |
| Program Services | $115,886 | ProgramServicesAmt |
| Management And General | $27,887 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,805 | TotalAmt |
| Program Services | $112,005 | ProgramServicesAmt |
| Management And General | $43,800 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $395,534 | TotalAmt |
| Program Services | $299,600 | ProgramServicesAmt |
| Management And General | $95,934 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,672 | TotalAmt |
| Program Services | $143,316 | ProgramServicesAmt |
| Management And General | $9,356 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,411 | TotalAmt |
| Management And General | $79,411 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,130 | TotalAmt |
| Program Services | $23,817 | ProgramServicesAmt |
| Management And General | $9,313 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT MEDICAL EXPENSES | $837,381 | $837,381 | |
| MEDICAL SUPPLIES | $71,536 | $71,536 | |
| COPIER | $42,395 | $30,477 | $11,918 |
| DUES/SUBSCRIPTIONS | $25,429 | $14,105 | $11,324 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,219 | TotalAmt |
| Program Services | $15,038 | ProgramServicesAmt |
| Management And General | $16,181 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,498,074 | TotalAmt |
| Program Services | $5,620,884 | ProgramServicesAmt |
| Management And General | $1,877,190 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $868,796 | BOYAmt |
| EOY | $938,397 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,772 | BOYAmt |
| EOY | $78,651 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $697,680 | BOYAmt |
| EOY | $769,813 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,469 | BOYAmt |
| EOY | $11,060 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,560 | BOYAmt |
| EOY | $75,795 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,108,620 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,015,573 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $171,510 | BOYAmt |
| EOY | $93,047 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,959,787 | BOYAmt |
| EOY | $1,966,763 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,077 | BOYAmt |
| EOY | $154,478 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $291,778 | BOYAmt |
| EOY | $328,279 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,855 | BOYAmt |
| EOY | $482,757 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,498,932 | BOYAmt |
| EOY | $1,484,006 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,498,932 | BOYAmt |
| EOY | $1,484,006 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,959,787 | BOYAmt |
| EOY | $1,966,763 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$14,926 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $257,093 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $253,246 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $346,681 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $308,602 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $238,997 | CurrentTaxYearAmt |
| Total | $1,404,619 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,901,807 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,812,709 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,902,706 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,206,229 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,244,151 | CurrentTaxYearAmt |
| Total | $46,067,602 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,158,900 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,065,955 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,249,387 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,514,831 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,483,148 | CurrentTaxYearAmt |
| Total | $47,472,221 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $47,472,221 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,158,900 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,065,955 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,249,387 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,514,831 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,483,148 | CurrentTaxYearAmt |
| Total | $47,472,221 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,108,620 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,015,573 | DepreciationAmt |
| Book Value | $93,047 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $93,047 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED VACATION | $239,263 |
| ACCRUED PAYROLL | $89,016 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $328,279 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $7,483,148 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $7,483,148 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $7,483,148 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,498,074 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $7,498,074 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $7,498,074 | TotalExpensesPerForm990Amt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOSHUA BLOOM MD | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | MED DIRECTOR | RelationshipDescriptionTxt |
| Transaction | PAID MEDICAL DIRECTO | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | DR. JOSHUA BLOOM WAS PAID 30,375. HE IS ON THE BOARD. | ExplanationTxt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | IN-KIND RENT | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $188,997 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | HOSPICE ALLIANCE HAS SERVED OVER 8,000 TERMINALLY ILL PATIENTS AND THEIR FAMILIES SINCE 1981; SERVICING KENOSHA, EASTERN WALWORTH, AND RACINE COUNTIES. HOSPICE ALLIANCE REMAINS COMMITTED TO CARING FOR THE TERMINALLY ILL AND EMPOWERING THOSE WHO SUPPORT THEM. INCORPORATED IN 1981 IN KENOSHA, WISCONSIN, HOSPICE ALLIANCE, INC. WAS ESTABLISHED BY A GROUP OF COMMUNITY CITIZENS THAT WERE CONCERNED WITH THE LACK OF END OF LIFE CARE AVAILBLE TO TERMINALLY ILL PERSONS AND THEIR FAMILIES. THESE COMMUNITY CITIZENS BELIEVED THAT IF TERMINALLY ILL PEOPLE WERE GIVEN A CHOICE AS TO WHERE THEY WOULD LIKE TO BE, IT WOULD BE IN THEIR HOME SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. HOSPICE ALLIANCE, INC. LIVES THIS MISSION DAILY THROUGH COMMITMENT, COMPASSION, AND CHOICES. HOSPICE ALLIANCE, INC. PROVIDES CARE IN THE FOLLOWING SETTINGS: 1. IN THE PATIENT'S HOME, SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. THIS CHOICE ALLOWS FAMILY AND FRIENDS TO SUPPORT THEIR LOVED ONE IN COMFORT AND PRIVACY. 2. IN LONG TERM CARE AND ASSISTED LIVING FACTILITES, SUCH AS NURSING HOMES, SENIOR APARTMENTS AND GROUP HOMES. HOSPICE ALLIANCE PROFESSIONALS COMPLEMENT THE CARE ALREADY PROVIDED BY STAFF IN THESE SETTINGS. 3. THE HOSPICE ALLIANCE HOSPICE HOUSE OFFERS AN OPTION FOR THOSE WHO, FOR WHATEVER REASON, CANNOT REMAIN IN THEIR OWN HOME. THE HOUSE OPERATES AT A SIGNIFICANT LOSS DUE TO HOSPICE'S MISSION. 4. PRE-HOSPICE PALLIATIVE CARE MAY BE THE CHOICE FOR SOMEONE WHO IS NOT READY FOR THE HOSPICE PROGRAM. 5. BEREAVEMENT SERVICES AND GRIEF SUPPORT GROUPS ARE AVAILABLE WHEN THE TIME IS APPROPRIATE |
| FORM 990, PAGE 1, PART I, LINE 6 | HOSPICE ALLIANCE VOLUNTEERS ARE A VITAL PART OF THE HOSPICE TEAM. WHILE ENHANCING THE LIVES OF PATIENTS AND THEIR FAMILIES, VOLUNTEERS GAIN SATISFACTION AND ENRICHMENT IN THEIR OWN LIVES. THERE ARE MANY WAYS VOLUNTEERS HELP, INCLUDING: COMPANIONSHIP, RESPITE CARE, RUNNING ERRANDS, NURSING HOME VISITS, MAILINGS, OFFICE HELP, COMPUTER WORK, EXPOS AND HEALTH FAIRS, FUNDRAISING, GARDENING, PREPARING MEALS AND BAKING. ALL VOLUNTEERS TAKE PART IN AN EIGHT SESSION TRAINING CLASS WHICH COVERS AN INTRODUCTION TO HOSPICE SERVICES, COMMUNICATION, DISEASE PROCESS, AND THE ROLE OF HOSPICE ALLIANCE TEAM MEMBERS. IN 2016, VOLUNTEERS COMMITTED 3,737 HOURS OF THEIR TIME. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WAS REVIEWED IN DETAIL BY THE FINANCE DIRECTOR AND BY THE ORGANIZATION'S FINANCE COMMITTEE AND THEN APPROVED BY THE FINANCE COMMITTEE. ALL FINANCIAL INFORMATION IN THIS RETURN IS BASED OFF OF THE AUDITED FINANCIAL STATEMENTS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | FULL DISCLOSURE, BY NOTICE IN WRITING, SHALL BE MADE BY THE INTERESTED PARTIES TO THE FULL BOARD OF DIRECTORS IN ALL CONFLICTS OF INTEREST. THIS IS DONE ON AN ANNUAL BASIS WITH BOARD MEMBERS, STAFF, AND VOLUNTEERS. IF THERE IS A POTENTIAL CONFLICT OF INTEREST, THE POLICY STATES PROCEDURES ON HOW TO HANDLE DIFFERENT SITUATIONS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE EXECUTIVE DIRECTOR'S SALARY IS DETERMINED BY THE BOARD. ALL OTHER STAFF SALARIES ARE DETERMINED USING THE NATIONAL ASSOCIATION FOR HOMECARE AND HOSPICE'S HOSPICE SALARY & BENEFIT REPORT AS WELL AS STATE AND NATIONAL GOVERNMENT WAGE DATA. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION WILL FURNISH AUDITED FINANCIAL STATEMENTS UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE ALLIANCE FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10220 PRAIRIE RIDGE BLVD | AddressLine1Txt |
| City | PLEASANT PRAIRIE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53158 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391822945 | EIN |
| Primary Activities | FUNDRAISER | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Public Charity Status | 12A | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|
| HOSPICE ALLIANCE FDN INC | |
| C | IN-KIND CONTRIB OF RENT |
| HOSPICE ALLIANCE FDN INC | |
| K | COST OF ANNUAL RENT |
| HOSPICE ALLIANCE FDN INC | |
| M | COST OF SERVICES |
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